OASIS Alert

Published on Sun Dec 05, 2004 PDF

December could be your last chance to claim the money you've earned.

If you have coding errors to correct, you may have to hurry.
 
Diagnosis coding continues to challenge home health agencies. Many are still finding out they have been coding incorrectly for years.

 If you forgot to put the case mix code in M0245, miscoded for CVA or made some other costly coding error, taking time to correct the mistake could be time well spent. The Centers for Medicare & Medicaid Services urges agencies to make corrections as quickly as possible after they detect errors so the system - which affects OBQI reports - will be as current and accurate as possible, says consultant Lynda Dilts-Benson with Reingruber & Co. in St. Petersburg, FL.

What to do: Correct errors in non-key fields - including M0230, M0240 and M0245 - by reopening the assessment, making the change, re-locking the assessment and re-submitting it, Dilts-Benson explains. Making this correction does change the lock date, which CMS usually requires to be within seven days of the assessment completion date. But for a corrected record CMS waives the lock date requirement, she adds.
 
CMS specifies that there are no rules requiring the coding correction within a certain time period, Dilts-Benson notes. But there are rules governing timeliness for correcting claims, explains M. Aaron Little, managing consultant with Springfield, MO-based BKD.
 
Deadline approaching: You must hurry to correct Medicare claims for episodes ending from Oct. 1, 2002 through Sept. 30, 2003. These claims must be corrected by Dec. 31, 2004, Little warns. You have until Dec. 31, 2005 to correct claims for episodes ending from Oct. 1, 2003 through Sept. 30, 2004.
 
Here's how: To correct a coding error for a claim you have already billed, first correct the assessment and re-lock and re-submit it. Then if you have billed only the request for anticipated payment, cancel the RAP and re-bill. If you have billed both the RAP and the final claim, simply correct the final claim, Little advises. 
 
Editor's Note: For information about correcting OASIS assessments, go to www.cms.hhs.gov/oasis/datasubm.asp.